Complete Response to Therapy

Back in July, the pain in my right leg escalated to a pretty serious point. I had been having a little trouble with it on my trip in June, but I had chalked it up to the extra walking and activity on the trip. However, when we returned the pain continued to worsen. My doctor first ordered an X-Ray and everything looked normal. But because the severity of the pain, she ordered a bone scan. Unfortunately, the bone scan looked ominous. Cancer seemed to be everywhere. My pelvis, my arm, my spine, my ribs, my skull, and, yes, both femurs. Which likely explained my pain.

Guess what……RADIATION again! The only reason I didn’t blink an eye was because it was going to possibly reduce or eliminate the pain in my leg. 5 shots to the right femur, and honestly, it was pretty easy. What wasn’t easy was the mental toll that scan took on me. I questioned my oncologist about progression. In April, when we did a PET/CT, there was nothing reported on my femurs or ribs, so it seemed as if  the chemo I am on, might be a bust. The femurs were easily explained as the PET/CT did not go low enough to see the spots on the femurs. The ribs, she reasoned, were possibly just too small to see at the time. She told me to do at least three more chemo treatments and then get another PET/CT. I reluctantly agreed, but was not so optimistic about the chemo doing its job. The good news is the radiation did reduce my pain. It did not eliminate it, but it is much more bearable.

Fast forward to August 9th….PET/CT day. This was tough as I wasn’t feeling good about it. I’m not sure why I scheduled it on a Friday knowing I would have to suffer the weekend wondering about the results. Maybe, underneath it all, I just wanted time to prepare for the worst news.

Sunday night I was hit with a major wave of anxiety. I knew the results would be in my email Monday morning. I started researching what type of chemo might be next on the menu. I got on my cancer discussion boards and asked for some encouragement. I didn’t want to go to sleep. Eventually, I decided it was time and headed to bed. But, not before deciding to clear out my email inbox.

I opened my email, and there it was. “Message from Kaiser.” I almost didn’t open it because usually when messages come through that late at night, it’s only an appointment reminder. But I opened it anyway and it was the results from my doctor.
When I clicked on the report, the first words I read were “Complete Response to Therapy.” Wait, what? What does that mean? I’ve never had a report say those words….EVER. As I continued to read, it meant that NOTHING was lighting up. No cancer was detected! If you know how a PET/CT Scan works, they inject you with a radioactive sugar and cancer consumes the tracer very quickly, thus “lighting up” the spots that are cancerous. And, as I said before, nothing was lighting up. Unbelievable.

So, anyone confused about how my bone scan had me planning my funeral and a PET/CT detected no cancer just a few weeks later? Yeah, me too! Bone scans do not “light up.” They show basically black spots where something is detected on the bone. “Something” could be cancer, could be scar tissue, could be old fractures, etc. Basically, it doesn’t discriminate between cancer and everything else. It was assumed that all of the black spots were active cancer because of my history and because that’s what we’re looking for. As it turns out, comparing PET/CT’s to Bone Scans is pretty useless. As my doctor said, we’re comparing apples to oranges.

What is useful is comparing a current PET/CT to a previous PET/CT. In April, I had three vertabrae with cancer, pelvic spots, a spot on my arm, and the ever present spot on my skull. If you’ll remember, this is when it was decided that I had to move on to IV chemo and I began the drug Taxol on a weekly basis. I knew the IV chemo would be tough, but had high hopes that it would also be effective. I never imagined it would be SO effective.

Now there is always a flip side to good news. The good news is my scan is clean for now, the bad news is the chemo is most definitely taking a physical toll. Neuropathy has kicked in so I have numbness, tingling, and pain in both  hands and feet. I’m tired and get tired very quickly. I’m bald. Gastro-intestinal symptoms are constant. I never know what or when those will hit. Everyday I wonder will it be heartburn, bloating, diarrhea, and occasional nausea. I’m on more meds to address side effects than I am to address cancer. That’s how this whole thing works. My oncologist told me that she cannot leave me on this chemo indefinitely as the effects will be cumulative. But, there are other options and possibilities that include dose reduction and/or taking breaks that can help with the side effects.

Now it’s important to note that the result of this scan DOES NOT mean I’m cured. There is currently no cure for Stage IV breast cancer. If I’m lucky, the drugs will hold the cancer at bay for many months, maybe years, but, in the end, it will return. We can only hope that it’s later and not sooner. For now, I’m just thrilled that it’s all under control and I can breath easier for at least a few months. I can count on being alive for some more trips and milestones. Thanks to everyone who always sends words of encouragement and love as I make my way down this road. It means so much to me!

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